Subconjunctival bleeding, also known as subconjunctival hemorrhage or subconjunctival haemorrhage, is bleeding from a small

blood vessel Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...

over the whites of the eye. It results in a red spot in the white of the eye. There is generally little to no pain and vision is not affected. Generally only one eye is affected. Causes can include coughing, vomiting, heavy lifting, straining during acute

constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The Human feces, stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the ...

or the act of "bearing down" during childbirth, as these activities can increase the blood pressure in the vascular systems supplying the conjunctiva. Other causes include blunt or penetrating trauma to the eye. Risk factors include hypertension, diabetes, old age, and blood thinners. Subconjunctival bleeding occurs in about 2% of newborns following a

vaginal delivery In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular sex organ, reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The #Vag ...

. The blood accumulates between the

conjunctiva In the anatomy of the eye, the conjunctiva (: conjunctivae) is a thin mucous membrane that lines the inside of the eyelids and covers the sclera (the white of the eye). It is composed of non-keratinized, stratified squamous epithelium with gobl ...

and the episclera. Diagnosis is generally based on the appearance of the conjunctiva. The condition is relatively common, and both sexes are affected equally. Spontaneous bleeding occurs more commonly over the age of 50 while the traumatic type occurs more often in young males. Generally no specific treatment is required and the condition resolves over two to three weeks. Artificial tears may be used to alleviate irritation.

Signs and symptoms

Subconjunctival bleeding initially appears bright red underneath the transparent bulbar conjunctiva. Later, the bleeding may spread and become green or yellow as the hemoglobin is metabolized. It usually disappears within two weeks. The affected eye may feel dry, rough, or scratchy, but the condition is not usually painful.

Causes

*Mechanical **Increased venous pressure (e.g. extreme

g-force The g-force or gravitational force equivalent is a Specific force, mass-specific force (force per unit mass), expressed in Unit of measurement, units of standard gravity (symbol ''g'' or ''g''0, not to be confused with "g", the symbol for ...

, straining, vomiting, choking, sneezing, coughing or

strangling Strangling or strangulation is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain by restricting the flow of oxygen through the trachea. Fatal strangulation typically occur ...

) or from straining due to

**External pressure changes: ***Atmospheric pressure changes due to aircraft altitude changes *** Mask squeeze from scuba diving without equalizing mask pressure during descent ** Eye injury or eye surgery ** Zygoma fracture (results in

lateral Lateral is a geometric term of location which may also refer to: Biology and healthcare * Lateral (anatomy), a term of location meaning "towards the side" * Lateral cricoarytenoid muscle, an intrinsic muscle of the larynx * Lateral release ( ...

subconjunctival bleeding) *Medical conditions that affect blood or blood vessels: **Severe

hypertension Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...

** Viral hemorrhagic fever ** Coagulation disorder (congenital or acquired) ** Acute hemorrhagic conjunctivitis (caused by including enterovirus 70, coxsackievirus A24 variant, and adenovirus 11) **

Leptospirosis Leptospirosis is a blood infection caused by the bacterium ''Leptospira'' that can infect humans, dogs, rodents and many other wild and domesticated animals. Signs and symptoms can range from none to mild (headaches, Myalgia, muscle pains, a ...

Subconjunctival bleeding in infants may be associated with

scurvy Scurvy is a deficiency disease (state of malnutrition) resulting from a lack of vitamin C (ascorbic acid). Early symptoms of deficiency include weakness, fatigue, and sore arms and legs. Without treatment, anemia, decreased red blood cells, gum d ...

(a vitamin C deficiency),

abuse Abuse is the act of improper usage or treatment of a person or thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, ...

or traumatic

asphyxia Asphyxia or asphyxiation is a condition of deficient supply of oxygen to the body which arises from abnormal breathing. Asphyxia causes generalized hypoxia, which affects all the tissues and organs, some more rapidly than others. There are m ...

syndrome.

Diagnosis

Diagnosis is by visual inspection, by noting the typical finding of bright red discoloration confined to the white portion (sclera) of the eye. In rare cases blood may drip from the eye.

Management

A subconjunctival bleeding is typically a self-limiting condition that requires no treatment unless there is evidence of an eye infection or there has been significant eye trauma. Artificial tears may be applied four to six times a day if the eye feels dry or scratchy. The elective use of

aspirin Aspirin () is the genericized trademark for acetylsalicylic acid (ASA), a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and inflammation, and as an antithrombotic. Specific inflammatory conditions that aspirin is ...

is typically discouraged.

References

External links

{{DEFAULTSORT:Subconjunctival Hemorrhage Disorders of conjunctiva Wikipedia medicine articles ready to translate